Document Detail

Evaluation of POSSUM in patients with oesophageal cancer undergoing resection.
MedLine Citation:
PMID:  12190681     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The Physiogical and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) has been used to produce a numerical estimate of expected mortality and morbidity after a variety of general surgical procedures. The aim of this study was to evaluate the ability of POSSUM to predict mortality and morbidity in patients undergoing oesophagectomy. METHODS: POSSUM predictor equations for morbidity and mortality were applied retrospectively to 204 patients who had undergone oesophagectomy for cancer. Observed morbidity and mortality rates were compared with rates predicted by POSSUM using the Hosmer-Lemeshow goodness-of-fit test. Evaluation of the discriminative capability of POSSUM predictor equations was performed using receiver-operator characteristic (ROC) curve analysis. RESULTS: The observed and predicted mortality rates were 12.7 and 19.1 per cent respectively, and the respective morbidity rates were 53.4 and 62.3 per cent. However, the POSSUM model showed a poor fit with the data both for the observed 30-day mortality (chi2 = 16.26, P = 0.002) and morbidity (chi2 = 63.14, P < 0.001) using the Hosmer-Lemeshow test. ROC curve analysis revealed that POSSUM had poor predictive accuracy both for mortality (area under curve 0.62) and morbidity (area under curve 0.55). CONCLUSION: These data suggest that POSSUM does not accurately predict mortality and morbidity in patients undergoing oesophagectomy and must be modified.
K D Zafirellis; A Fountoulakis; K Dolan; S P L Dexter; I G Martin; H M Sue-Ling
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  89     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-08-22     Completed Date:  2002-09-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  1150-5     Citation Subset:  AIM; IM    
Division of Surgery, The General Infirmary at Leeds, Leeds LS1 3EX, UK.
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MeSH Terms
Aged, 80 and over
Esophageal Neoplasms / mortality,  surgery*
Esophagectomy / methods,  mortality*
Middle Aged
Risk Assessment
Risk Factors
Sensitivity and Specificity
Severity of Illness Index
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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